Month: January 2018

If you’ve never heard the saying that one works for decades in order to become an overnight success, then you’ve heard it here first.

I’ve been in PT for 10 years and am now getting mentioned in conversations with people that I’ve looked up to for years. At one point, someone was shocked that another student didn’t know who I was. I find it comical.

As the son of a laborer, especially one that worked in the sewer systems, I have always had a strong work ethic. For 10 years I’ve kept my head down, avoided causing any waves and just worked. I worked through a divorce. I worked through a fainting episode. I worked through a cardiac issue. I worked. It’s what I’ve always known. I guess I’m just too dense to know any different.

One thing that I am realizing after all these years is that I gained a lot of knowledge by working with patients, working in study groups and working at night by reading journals. I worked hard and now I’m starting to speak out more from behind the computer.

I have a lot of passions for this profession, but this profession is just that…a profession. At some point I will leave it and move on, but while I’m here, I want to have an IMPACT.

Jim Rohn said “If you let your learning lead to knowledge, you become a fool. If you let your learning lead to action, you become wealthy.”

I’m starting to take action. For those that follow my blog, keep your eyes and ears opened because I am creating a CEU that will encompass our profession, but I believe that it will transcend our profession.

I am not doing this for the money. I am sick of hearing the negatives of our profession. I chose to look at these negatives systematically to try to determine how I can help. I think I know how to create waves and make an IMPACT.

I went months without setting a PR when I was powerlifting. It was horrible. When I first started, I made gains weekly just by walking into the gym and breathing the musky air from the dungeon. I could stand next to the strongest guys, and women, in the world and get stronger from their aura. It wore off over time and I had to come out with some tactics to get stronger. I’ve used chains, rubber bands, static holds and changed the tempo of the repetition. I did what I had to in order to make progress, albeit slow progress at times.

Now, I’m a Doctor of PT and I am managing a clinic. During the Fall, times were a boomin’, but the winter brings with it a season of decreased want to leave the house. People don’t want to come to therapy multiple times per week in order to alleviate pains that have been there for years. “It can wait another month”, they think. “It can wait until winter’s over”, they think. If they only knew that the solution could be easy!

Wait…that’s my job to educate them!

I was once told that if you build it, they would come. Well, that guy was wrong and I’m busting my behind in order to get them to come.

These times of scarcity allow for some time to create my brand, donate my time to the communities and allow me to learn more about the people that I will serve. It’s hard to watch the numbers go down in the gym, but it’s very frustrating to know that I am going through these patterns over again 10 years later.

“Customers and employees come and go. Supporters are with you for the long haul.”

Blake Mycoskie, Founder of TOMS shoes

I recently took over as a manager in an outpatient physical therapy clinic. I would love to say that I came in and that business is booming, but it’s not so…yet. I’m busting my tail and those patients that have come into the clinic are no longer just patients. They are supporters. Heck, they might as well be a giant billboard walking around town. I’m getting new patients coming in and their doctors are telling them that they are hearing great things about me and the clinic! This is exciting. It takes a small event to create a ripple in the ocean. That one patient telling the prospective patient about me and the clinic is the rippling effect that I need.

Not everyone needs PT. It’s a shock to hear that coming from a PT! I’m telling you that you may not need my services, which in turn means that you won’t spend your hard earned money on my services. Financially, this statement hurts, but I learned from a wise business man that service to the people is the most important part in business. I had the opportunity to hear his story and ask questions about his journey. This man has a following, with me included in that line. He built a career on serving his customers and creating supporters.

This guy is one that I will attempt to emulate in the coming years. Doing good deeds can’t hurt anyone. When I go back and review these blog posts next year, I’ll give an update on my attempt to emulate the best businessman that I had the opportunity to chat with this year.

As you can see, I’m in the middle of reading the book from Blake Mycoskie, founder of TOMS shoes.

I have never really had to work hard for anything. At least I don’t consider what I did hard work. I was comfortable. I had goals, but knew that they could be achieved with just a little bit of time and a continuation on the trajectory of life that I was on. BOY WAS I WRONG!

My awesome wife is a PTA and wants to go back to become a Doctor of Physical Therapy. We had our tentative plans on place for her to apply (and of course get accepted) into one of the two programs in the country that allow for this transition. We, meaning she, was pregnant at the time and were expecting to love after the baby was born.

Life happens and sometimes there are situations that you can’t predict or prepare for in life.

Our second daughter was born with Down Syndrome. We weren’t aware of it until the next day, as we were parents enjoying the birth of a child. Our lives changed that day. I can speak from my perspective.

I became afraid.

I wondered how will I support this child through adulthood?

I see and try to prepare for worst case scenario at all times?

Will my child be able to take care of herself?

Will my child be able to hold a job?

Will my child be able to live alone?

All of these questions have to be faced by parents with a special needs child. I don’t like to wait for things to happen in life, but like to prepare and over prepare.

I was afraid that I would fail my child and therefore fail my family, my wife and my children. That fear lit a fire under my ass that I have never had before. There is more focus now than I’ve ever had previously.

Here’s the sad part…it’s not hard to shoot to the upper echelon of our profession. Since my daughter’s birth, I worked and worked on creating myself as a brand. This was to prepare for a move that had to happen. I now need to create a legacy for my family. I was comfortable at my previous job, but it wouldn’t have provided the amount of financial stability that I needed to possibly support a child through retirement. I had to make a move.

I worked on building a brand and within 1 year was named among the top 40 influencers in our field by Updoc media. I started mentoring PT students and other PTs throughout the country. I started a Facebook show called People you should know. I doing more volunteer work now than I had in the previous years.

I thought that I was “busy” before Natalia was born, but now I’m no longer busy…I’m productive. I opened a clinic in Joliet with the purpose of trying to give back to the entire city. It’s been said that if you want to make a million dollars, you have to help a million people. My mission has been set to help as many people as I can because I know that this is the only way to face my fear of failing my family.

If you found this to be inspiring, informative, or entertaining…share it so others can read and learn from my experience.

We all have a story. I actually have spent a good amount of my time recently learning about other people’s, group’s and mission’s story on my FB page People you should know. My story started a long time ago, but I won’t bore you with the details. The one part of the story that is most important is that I always look for the next opportunity to succeed. At Sam’s club, I was named employee of the year in 2013 and quit soon thereafter because I had reached my ceiling. There was no other Hill to climb or challenge to face. I know that it sounds like a small feat, but I worked hard to reach that status. Unfortunately, the journey was worth more than the victory, because my journey seemed complete.

My PT career has taken a similar trajectory. I started in a clinic, that I was excited to work at, in order to learn as much as I could. After 2 years, I lost that zest because I was more like a robot than a sponge. I wasn’t learning…growing…as much as I was simply going through the motions of treating patients. It sounds horrible, I know, but I was pretty good at using the McKenzie Method back in those days. If you’re familiar with Mariano Rivera, you know that he had one pitch. It was an unhittable pitch for a long period of time. He built a career on throwing his “cut fastball”. I spent more than two years honing my craft as a McKenzie based PT, but after 2 years I felt like the game wasn’t any fun anymore. I remember taking the trash out after 18 months on the job and thinking that I was “bored” with my job and could treat patients with back pain while dreaming.

Not soon after, I left that job and took a hefty pay cut in the process (you’ll start to see a pattern that I didn’t see until recently). I switched to a hospital-based outpatient department. Mind you, for two years I saw nothing but patients in pain with a generic diagnosis of: low back pain, neck pain, shoulder pain, knee pain, hip pain so on and so forth. I don’t mean to demean the patient’s pain, but c’mon “low back pain”?! Is t that what the patient told the doctor at the beginning of the session. The doctor then turns around and gives the patient a referral to PT stating back pain. (Venting a little).

At the hospital, I encountered something that I hadn’t encountered in the two previous years…a protocol! A protocol is similar to the old book “paint by number”. There is. O significant thought that goes into treating these patients post-surgically because we are bound to treat the patient by following the directions given. I had the hardest time treating patients post-surgically because I spent the previous 2-3 years with constant algorithms floating through my head. Think John Nash from “A Beautiful Mind”. I may be exaggerating, but that’s what it feels like at times. For those two years I was playing a chess match with the patient’s symptoms and pain. I was always playing 5 moves ahead with an answer for every patient move. (A patient move is considered his/her response to a previous exercise or intervention. For instance, a patient can only always respond one of three ways: better, worse, same). I had a response for each of these answers and just worked through this chess match with each patient. My biggest fear was “paint by number” because the patient would come in and…game was already over because I couldn’t make any moves.

I digress.

I matured while working at the hospital. I learned to be a team player instead of playing clean-up or closer. I learned that when horses pull in the same direction that they can pull harder than they could as individuals. Unfortunately, I also learned something else about me…I hate when the game is over. I continue to search for ways to grow and be better day-day. I reached the end of my limit at the hospital because the opportunities to play and grow were no longer available.

This is where my story starts again. This time, this time, the game is much bigger. The chess board has expanded. The moves I can make are multi-variable. I liken my current position in the profession like playing a continuous chess match in which the boards are suspended above each other like floating plates. When one piece gets taken it gets placed on the board above the previous board. The game ends when all of the pieces make it to the top board and only one piece remains. There is no tipping pieces. There is no quitting. Only moves and reactions. This is the equivalent to the biggest algorithm I have ever got to play inside. I can make on”wrong” moves, only temporary losses.

Life is pressure, but the game is fun.

Goodnight all.

Thanks for reading some of the late night ramblings.

Btw, the quote was from Blake Mycoski in “Start Something That Matters”.

“You don’t always need to talk with experts;sometimes the consumer, who just might be a friend or an acquaintance, is your best consultant.”

Blake Mycoskie

This is more apparent now than it has ever been. As a practicing clinician for over 10 years, the patient’s/consumer’s/acquaintance’s input mattered, but it played a small role in how I would change. Not to belittle the advice, but I was getting great outcomes in patient care and was just making great strides clinically over the past decade. My patients had little to offer in terms of things to change.

Fast forward to now and I am a clinic director taking on the same struggles that other new businesses face. Not many new patients are walking through the door. I will always be my biggest critic, but at this point, the words of wisdom given to me by patients and family members is worth gold.

“You have no visibility from the street.”

“No one knows that you are here.”

“You need to get out more to the older communities.”

“You should advertise in the local newspaper.”

“You should give more talks to churches.”

“You should go to neighborhood associations and speak”

All of these are great pieces of advice. Some are more doable than others because advertising takes money. Fortunately, since I have time on my hands, I am reaching out to different organizations for speaking opportunities.

Listen to your ideal client because they know how to reach more people like him/her.

This quote gets thrown around, but how often do we stop to analyze it?

What is the change that I want to see?

1. I want all PTs to have easier access to research.

2. I want the public to be more aware of the difference between good PT and bad PT services.

3. I want the public to know that a. PTs exist b. how PT is covered by insurance related to out of pocket costs c. and how PTs can help with physical issues.

4. I want PTs and students to be humbled and ask for help when needed and offer help when able.

Hello 2018, I got some lofty wants.

How have I started to accomplish these goals

1. Writing a blog and putting out videos describing the research that I am reading on a daily basis.

2. Giving community lectures educating the public regarding what to expect from a physical therapist. Educating the public on the core values and how some practices may demonstrate the practices. Unfortunately, I also highlight how some may not practice according to our profession’s core values.

I also started posting reviews of some of the neighboring clinics on social media when these clinics aren’t practicing in an ethical fashion.

3. Again, the blog and community lectures serve to educate the public of our existence and during these lectures I typically explain Medicare Part B regulations and coverages so that the potential patient can feel more comfortable about their responsibility financially.

4. To help others in areas of my strengths I do one-one conversations on FB, via telephone and in person. I readily ask for help when I am stuck and believe that I have a team of Avengers that I can reach out to at all times of the day.

“We do not rise to the level of our expectations. We fall to the level of our training”

This quote is taken from the Tim Ferriss book Tools of Titans.

In PT, we all believe that we will change the world. We have visions of grandeur in which we take patients from wheelchair to playing field. Preventing surgeries, curing world health problems and wearing a red cape with a big “S” on our chest…okay maybe not all of us have these dreams.

In the end though, our patients are doomed to fail if they see a PT that has not lived up to his/her professional duties of continuing education. In Illinois, we are required to obtain 40 hours of continuing education every 2 years.

Let’s think about this number. It’s been said that one needs about 10,000 hours to master a topic. That’s a lot of years if one takes the minimum amount of hours. At that pace, one can never become a master of anything other than a long commute.

When choosing a therapist, there has to be more thought put into it than your next vacation. You are spending your hard earned money…or the insurance company’s money…don’t you want to know that the person treating you is actually good at what they do?

Have they taught classes? Have they studied independently? Are they giving back to the community?

HELL, let’s start at the basics…do they pay attention to you when you’re in the clinic? Not in a three ring circus kind of way, in which they are just managing the acts that come in and send the patient from machine to machine, but are they paying attention to YOU?

I’d love to think that everyone in this profession of PT is operating up to his/her expectations, but deep down I know that we operate at or below our training. Not all PTs have the same knowledge.

Having spent time in the profession, I can state that I’ve seen the top 5% of the profession, and they are awesome. Unfortunately, it’s only the top 5%. The rest go nameless like worker bees to support a queen. There are very few queens in this industry and if you do a quick search, you can find those companies that make the most, are worth the most, are publicly traded etc.

We just want to help people. That’s the number one answer I hear from students entering the field, unfortunately not everyone continues to practice in this mentality once out of PT school.

We need to live up to our expectations more and improve our training to reach those expectations.

This quote is from an excerpt of a conversation with Amelia Boone from “Tools for Titans”.

Growing up with 5 brothers and a sister, I learned that I wasn’t owed anything and that I had to work to get anything. My brothers were great baseball players and my sister had a mean tennis serve. I wasn’t built to be an athlete. At least that’s what I told myself.

In my neighborhood, college wasn’t an expectation or even an option unless one was a master of sport. Our area wasn’t known for producing scholars.

This would be my path. My parents sacrificed in order to send me to a private high school, where it would be hard to fit in because my upbringing wasn’t the “Leave it to Beaver” type. I had more in common with JJ Walker than Wally Cleaver.

I was descent at sports, but I knew I couldn’t play. I saw sports as a gateway to failure. I saw too often how excelling at something could lead one down a broken road. I chose not to play.

I instead joined the honors group at Providence. It was a small group of about 30 of us. One of the coaches said we weren’t “that smart, just knew how to cheat better”. He was partly correct, we knew how to cooperate to win.

What’s all this have to do with physical therapy?

In the end no one owes you anything. Having finished PT school, it was time to rest on my laurels and collect a paycheck. It was time to treat every patient that walked through my door the same as anyone before him/her. It was time to take the easy road…because I earned it.

Anyone who knows me, knows that I am blowing smoke.

I still follow this saying that I’m owed nothing and bust my tail to continue to learn and produce. I treat each patient as a new patient, even if it’s a presentation I’ve seen hundreds of times before, because it’s possible that there will be something with this presentation that will help me with the next hundred.

I never get to “cash it in” because I haven’t made it yet.

I have a pattern in life and it’s very apparent. My mom brought it to my attention about 15 years ago. The pattern is that once I’ve climbed the mountain and made it to the top…I pivot. The juice is always worth the squeeze, even when there is no juice.

There’s always something to learn, something to accomplish and another mountain to climb. I only wish that everyone could live a live never feeling like they were owed anything.